glomerular filtration rate

Overview

Glomerular filtration rate (GFR) is a fundamental physiological measure of kidney function, reflecting the volume of plasma filtered by the glomeruli per unit time. In clinical practice, it is used to assess renal function, stage chronic kidney disease, monitor acute kidney injury, and guide eligibility, dosing, and safety decisions in many therapeutic settings. Because direct measurement is complex, GFR is often estimated using serum creatinine-based equations, including estimated glomerular filtration rate (eGFR), or measured with exogenous clearance markers in research and specialized clinical evaluation.

As a biomedical target in recent literature, GFR appears primarily as a renal function endpoint and stratification variable rather than a molecular drug target. It is frequently interpreted alongside creatinine, cystatin C, blood urea nitrogen, albuminuria, and other markers of kidney injury or progression. In studies of type 2 diabetes, chronic kidney disease, diabetic kidney disease, HIV treatment, immunosuppressive therapy, and kidney fibrosis, changes in GFR or eGFR were used to define kidney damage, predict outcomes, or evaluate treatment safety and efficacy.

Focus of Latest Publications

Recent investigations of glomerular filtration rate (GFR) have highlighted its role as both a clinical assessment tool and a prognostic biomarker across multiple therapeutic contexts. In patients receiving nephrotoxic agents, individualized estimated glomerular filtration rate (EGFR) assessment has emerged as essential for treatment planning. Specifically, in concurrent chemoradiotherapy for head and neck cancer, EGFR measurement guides dosing of cumulative cisplatin, where doses ≥200 mg/m² are associated with improved outcomes yet carry significant renal toxicity risk. This interplay between renal function and drug delivery exemplifies the need for baseline and serial EGFR monitoring in patients receiving agents with known nephrotoxic potential.

Beyond dosing optimization, EGFR functions as an informative biomarker for predicting long-term treatment outcomes. Recent methodological work demonstrates that acute changes in EGFR following initiation of sodium glucose cotransporter-2 (SGLT-2) inhibitors can inform expected effects on clinical endpoints in chronic kidney disease patients, though distinguishing true treatment-induced changes from natural biomarker variability remains statistically challenging. Notably, advances in GFR measurement techniques—including validation of mannitol clearance as an alternative marker in stage 3–4 chronic kidney disease—expand diagnostic options when standard methods such as iohexol or radioisotope clearance are contraindicated.

In type 2 diabetes, EGFR serves as a standard metric for monitoring kidney disease progression, with recent evidence indicating that fasting urine osmolality may provide additional prognostic information beyond EGFR reduction and albuminuria. At the clinical trial level, EGFR and creatinine clearance continue to dominate as eligibility exclusion criteria in hematologic malignancy studies, appearing in over 40% of phase 3 randomized controlled trials. These widespread exclusions—particularly in trials of chemotherapy and those with commercial sponsorship—raise questions about evidence gaps in drug safety and efficacy for the substantial proportion of patients with concurrent renal impairment, highlighting the tension between trial homogeneity and real-world applicability.

Key Publications

• NEWJul Association Between Individualized Estimated Glomerular Filtration Rate and Cumulative Cisplatin Dose in Head and Neck Cancer. (Anticancer research, 2026, PMID 42373265): "This study investigated the association between individualized estimated glomerular filtration rate (eGFR) and cumulative cisplatin dose in patients with head and neck cancer undergoing CCRT."
• NEWJun Multi-omics investigation of per- and polyfluoroalkyl substances in lung adenocarcinoma: comprehensive network toxicology, machine learning and molecular docking experiments. (Molecular diversity, 2026, PMID 42334505): "Consequently, we identified six hub toxicological targets: HSP90AA1, EGFR, AKT1, ALB, SRC, and ESR1, highlighting their potential central roles in PFAS-driven LUAD pathogenesis."
• NEWJun Small-molecule inhibitors of the protein kinase DYRK as potential therapeutic candidates in cancer. (Cell chemical biology, 2026, PMID 42269611): "DYRK1A drives glioblastoma (GBM) progression via stabilization of epidermal growth factor receptor (EGFR)."
• May Chemical Profiling and Scaffold-Based Drug-Discovery Analysis of Bioactive Compounds from Ceratonia siliqua L. with Computational and Biological Validation. (Journal of chemical information and modeling, 2026, PMID 42206975): "To further bridge the gap between the identified scaffolds and their corresponding biological activity, molecular docking was performed against key biological targets, including KEAP1, Staphylococcus aureus DHFR, and EGFR."
• May Design and Pictet-Spengler enabled synthesis of carboxamide-substituted imidazo[1,2-a]quinoxalines as dual EGFR and tubulin targeting anticancer agents. (Journal of enzyme inhibition and medicinal chemistry, 2026, PMID 42179048): "In this study, we report the Pictet-Spengler enabled synthesis of a series of eighteen carboxamide-substituted imidazo[1,2-a]quinoxaline derivatives (JRC-1-JRC-18) targeting epidermal growth factor receptor (EGFR) and tubulin."
• May Efficacy and safety of first-line osimertinib in Chinese patients with EGFR-mutated advanced non-small cell lung cancer: a prospective, multicenter, non-interventional study (FLOURISH). (Cancer biology & medicine, 2026, PMID 42170792): "Osimertinib has demonstrated superior efficacy as a first-line treatment for epidermal growth factor receptor (EGFR)-mutated non-small cell lung cancer (NSCLC) in clinical trials."
• May Single-nucleotide variant profiling in liquid biopsy with RECO-Cas. (Science advances, 2026, PMID 42172311): "Using the assay, we detect KRAS, EGFR, and PIK3CA point mutations in cfDNA from clinical plasma samples, demonstrating high sensitivity (90.48%) and excellent specificity (100%)."
• May Tumor-targeted bispecific antibodies effectively inhibit oncogenic pathways while minimizing toxicity. (Science advances, 2026, PMID 42172336): "Expanding this approach, we developed tumor-targeted, toxicity-sparing bispecific antibodies against fibroblast growth factor receptor 1 (FGFR1) and epidermal growth factor receptor (EGFR)."
• May Novel bispecific T-cell engagers overcoming acquired EGFR resistance. (mAbs, 2026, PMID 42152476): "Epidermal growth factor receptor (EGFR) is a validated therapeutic target in several human cancers harboring wild-type KRAS."
• Jun Engineering a β-Sheet Enables Bispecific Binding in Single VHH Domains. (ACS synthetic biology, 2026, PMID 42152502): "We used this platform to engineer multiple dual binders to two target combinations: EGFR/PD-L1 and HER2/TfR."